Graduated: 2000
NPI: 1881646875
Practice Locations (2)
NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC
400 WALMART WAY, SUITE F
DAHLONEGA, GA 305330829
7068677666
THE LONGSTREET CLINIC, PC
725 JESSE JEWELL PKWY SE
GAINESVILLE, GA 305013834
7705336511
Source: CMS National Downloadable File, September 2026.